Annual Address 
BY THE PRESIDENT 
FORDYCE BARKER, M.D. 
OF NEW YORK 
REPRINT FROM VOLUME I 
©jmecologfcal 
1876 ANNUAL ADDRESS. 
FORDYCE BARKER, M. D., PRESIDENT, 
New York. 
In this memorable year of our nationality, we have organ- 
ized a society having for its object, as expressed in our Con- 
stitution, the promotion of knowledge in all that relates to 
the Diseases of Women and to Obstetrics. 
We have now met for the first time, to begin our work ; 
and may we not hope that at the annual gathering of each 
coming year, this work may be done so well that when an- 
other hundred years have passed, the centennial anniversary 
of this Society may be well worthy of commemoration by 
those who are to succeed us ? May we not confidently an- 
ticipate that this Society will exert a marked influence in 
stimulating inquiry, investigation, and recorded observation, 
and thus be an important agent in contributing to the prog- 
ress of science and our national reputation in this branch of 
our profession ? May we not secure for it such a charac- 
ter, by zealous, honest, able work, as that all who aim for 
reputation in the department of Obstetrics and Gynecology, 
will seek to obtain membership, as giving the seal and stamp 
of eminence ? Can we not now, in the beginning of its 
career, give it such a direction, impress, and tone, that each 
annual volume of our Transactions shall contain papers of 
value so great that all intelligent men in the profession, who 
strive to keep abreast with the progress of science will desire 
to secure a copy, and that at the centennial anniversary of 
this Society a hundred volumes of its Transactions will fairly 
represent our national contributions to the progress of sci- 
ence and art in Obstetrics and Gynecology ? 
If the future of this Society prove to be as great a suc- 
cess as I am sure we all hope it may, then he who sug- 2 
ANNUAL ADDRESS. 
gested its formation, and those who have assisted in its or- 
ganization, have done a great work and will be entitled to 
high honor therefor. I may say this frankly, because I can 
lay no claim to the honor of either suggesting or planning 
its organization. 
I cannot adequately express my appreciation of the unde- 
served honor which I have received at your hands, an honor 
which I esteem more highly than any that has before been 
conferred upon me. Fully conscious as I am that there are 
others who have a much better claim to the position of Presi- 
dent from what they have done by their contributions in lit- 
erature and science, or from the important improvements in 
practice which they have originated, I accept the distinction 
as an expression of personal kindness. Failing in words to 
appropriately acknowledge this kindness, I can only show 
my gratitude by a zealous, honest effort to perform the duties 
of the office so as to secure for our meetings the most effi- 
cient work. I hope for a measure of success, because I rely 
with confidence upon your kind aid and hearty cooperation. 
As you all know, the conception of this Society originated 
with a gentleman who deemed this an appropriate year to 
combine in a national organization certain representative 
men who had become prominent by their writings and their 
labors in Obstetrics and Gynecology. By personal con- 
sultation and correspondence with a considerable number, 
as large as the limited time would permit, it was found that 
the scheme was regarded with great favor. A meeting was 
called for organization, which was attended by gentlemen 
from several of the largest cities of the Union, and which 
was endorsed and approved by correspondence which repre- 
sented every part of the country. In the organization of the 
Society, it was deemed wise to have the number of members 
limited, so that active working men only should be enrolled 
and membership esteemed an honor ; and as the time had 
been too short for consultation and approval of all whose 
position and reputation would secure membership, only two 
thirds of the full number admissible were elected. It was 
from no invidious discrimination that some, who are entitled ANNUAL ADDRESS. 
3 
by what they have done, either in Obstetrics or Gynecology, 
to an original membership equally with those who are in- 
cluded, have been left out, but it was because, either from 
lack of personal acquaintance or from their topographical 
position, there was no opportunity to ascertain their wishes 
and their views in regard to the scheme. It is confidently 
believed that these will seize an early opportunity to become 
members, by presenting such papers as will do honor to 
themselves and to the Society. The influence of a few such 
men, whose reputation is already established, will do much 
to stimulate others, who have a growing reputation but still 
a name to make, to work in the same direction and adopt 
the same means for gaining membership. The decision of 
the Council to publish in each volume of the Transactions a 
complete bibliography of everything that appears pertaining 
to Obstetrics and Gynecology during the current year, not 
only in English but in foreign literature, will undoubtedly se- 
cure to papers in these Transactions a larger class of special 
readers than could be obtained through any other medium of 
publication. 
The status of this Society in the scientific world, will be 
determined by the character and value of the papers pub- 
lished in its Transactions, and by the tone and ability of 
its discussions. I cannot permit myself to doubt that it will 
soon attain such a position that the title, “ Fellow of the 
American Gynecological Society ” affixed to the name of the 
writer of a paper on any subject which relates to Obstetrics 
and Gynecology, will be so strong a presumptive evidence 
that such a paper must have value, as to secure perusal from 
all interested in the topics discussed. 
I hope that it will not be considered as offensively pre- 
sumptuous on my part, if I venture to offer a few sugges- 
tions in relation to the character of the papers which are to 
be laid before the Society and also in regard to the discus- 
sions at its Annual Meetings. The papers which the So- 
ciety will receive must necesarily be of two classes. 
(i.) Those which would be useful and interesting to be 
read and discussed at our meetings. 4 
ANNUAL ADDRESS. 
All subjects relative to questions in pathology and practice 
which have not yet been settled by the general sentiment of 
the profession will most appropriately belong to this class. 
On many questions it is to be presumed that members have 
given much thought and study and can bring to bear on 
their discussion the results of mature inquiry and a clear and 
forcible statement of the reasons which have lead to positive 
convictions and well defined rules of practice. In some 
papers, the novelty of opinions advocated and the original 
methods of practice proposed, whether medical or surgical, 
may be so exclusively a matter of individual experience, that 
all discussion at first must necessarily be limited to inquiries 
and a priori objections, founded on anatomical, physiologi- 
cal, or pathological grounds. Papers of this class should be 
the subject of a most searching and thorough examination; 
for they may be either mischievous, and their effect for evil 
must be effectually exposed, or they may possess positive 
value which should lead to prompt acceptance and adoption. 
No doubt many such will be offered to us, which will require 
the continued discussion and the accumulated observation of 
years, before the question is absolutely settled. There are 
many such questions still open in practical Obstetrics and a 
larger number in subjects connected with Gynecology. As 
opinions and rules of practice based on the experience of a 
thousand observations often reverse the opinions and rules 
of practice based on the experience of hundreds and tens, so 
many questions, which we now deem settled, will, as observa- 
tions which are thoroughly to be trusted accumulate in the 
larger proportions of thousands and millions, have to be re- 
opened and new results both as regards doctrine and prac- 
tice will be reached. 
One of the useful results which flow from the formation of 
societies for the advance of science, is that it leads to origi- 
nal and independent research and has a tendency to over- 
come blind reverence for authority. Thus it may happen, 
and it often has happened in science, that one stands alone 
One who has most thoroughly studied a subject in all its 
aspects, and who has convinced himself, by what he believes ANNUAL ADDRESS. 
to be incontrovertible facts and careful reasoning, that the 
opinions he holds are sound, may find himself like the jury- 
man associated with eleven obstinate men. But truth will 
eventually triumph ; and the personal consideration whether 
the one or the eleven be obstinate, is a matter of no impor- 
tance. If writers on scientific subjects only appreciated how 
indifferent the world is to personal controversies, with what 
aversion and contempt it regards abuse, with or without ar- 
gument, much of the acrimony and bitterness, which unfor- 
tunately often mar the discussion of questions of science, 
would disappear. In general, the violence of the personal 
abuse is in inverse ratio to the importance of the subject. 
As for example, 1 have seen nothing which surpasses the 
ferocious temper and violent denunciations of philological 
disputants, where the whole subject of controversy is only 
what Hamlet avowed that he was reading, “ words, words.” 
(2.) A second class of papers is of such a character that no 
one could listen to the reading of them with interest or ad- 
vantage. The time of the Society could be better occupied 
than by the hearing of papers of this kind, because they 
require careful perusal and private study. There is a large 
class of topics, which it should be the province of this So- 
ciety to examine, that cannot be properly treated in a foren- 
sic discussion. All practical questions, which involve great 
statistical research, analysis, and deduction, and all papers 
based on original physiological, anatomical, and pathological 
studies, must come under this category. 
As illustrating what I mean, I may refer to a paper by 
one of our Fellows, published many years ago, on Rupture 
of the Uterus, which every writer on the subject at the 
present day is compelled to allude to and quote from ; to 
a paper which has recently been published by another of our 
Fellows on the Internal Structure of the Uterus ; and to 
another essay by a gentleman in Cincinnati, on Erysipelas 
and Childbed Fever, published a year ago. 
Now, papers of this class would most appropriately appear 
in our Transactions; they would help to give the Society a 
high scientific position, and to cause a demand for our 
5 6 
ANNUAL ADDRESS. 
Transactions by reading, thinking men in the profession 
outside of our Society, but they are not such papers as could 
be profitably read at our meetings. 
Let it then be understood at the beginning, that the vote 
of the Council to publish a paper, but not to have it read at 
our Annual Meeting, is not an expression of opinion as to its 
merit, for undoubtedly such will be the action of the Council, 
in regard to some of our best papers. 
We have a right to expect papers of value from candidates 
for membership. I beg to suggest that those which possess 
such merit as to secure from the Council a nomination for 
election should be published in our Transactions, but that 
the names of those who are unsuccessful be kept secret, and 
that the authors be informed that their papers can be re- 
turned. There may be every year more or less of such 
papers well worthy of publication in Medical Journals, but 
which fail to reach that standard of excellence which should 
secure membership. In the Academy of Medicine of Paris, 
and some other societies, where election to membership is a 
test of high attainments, candidates frequently fail to secure 
an election, two or three times successively, who afterwards 
attain the position sought for, and in some instances they 
have been the members who have reflected upon the society 
its highest distinction. Without insisting that our selection 
of members should depend solely or even chiefly on the liter- 
ary quality of the candidate, we surely may demand that one 
who has acquired such a reputation as to make him a desir- 
able member of the Society should furnish such a written 
justification of that reputation as would merit a place in our 
Transactions. 
As regards the discussions at our meetings, I may be 
permitted to say that they should be the expression of care- 
ful study, deliberate judgment, and mature experience. The 
time of the Society is too valuable to be taken up by listen- 
ing to the crude, impulsive, badly-arranged outbursts of the 
moment; and no thoughtful man will run the risk of jeop- 
ardizing such a reputation as a Fellowship of this Society 
should imply, by speaking on a subject, unless he has al- ANNUAL ADDRESS. 
7 
ready formed distinct opinions, and can clearly state the 
mental processes by which he has arrived at these opinions. 
I am far from intending to suggest that our discussions 
should be written out and read. This would destroy all 
rhetorical brilliancy in debate, all liveliness of repartee, and 
indeed the life of our meetings. The keen analysis which 
finely dissects the fallacy of an argument, the good humored 
sarcasm which makes clear and transparent an absurd prop- 
osition, if spontaneous and impersonal, will be enjoyed by all, 
even by the victim ; but the same weapons of debate, if 
written in cold blood and deliberately read, often sound 
brutal, and are offensive to good taste and good feeling. 
So let us by all means encourage and sustain oral discus- 
sions and make them as lively and brilliant as possible, but 
never personal! In scientific societies, for some reason 
which philosophy has not explained, it seems especially 
necessary to guard against a sensitiveness which assumes 
that a criticism is intended to be personal, when the attack 
is directed only against the statements, reasoning, and doc 
trines of the person. It, of course, is the duty of the chair 
to guard against personal attacks, and if any one should feel 
that he is attacked, he should deem it unnecessary to defend 
himself, for his most effective defense will be found in the 
contempt and aversion felt toward the aggressor. It is to 
be anticipated, that papers will be read on controverted 
pathological doctrines, obscure points of diagnosis, and dis- 
puted questions of practice ; and it will be mainly papers of 
this class which will give rise to oral discussions. We may 
expect that those who have studied in the same direction 
will be able to add other facts, either confirming or refuting 
the doctrines advocated. No one has a right to complain if 
ignorance of the science of the past be exposed, if false as- 
sumption be made manifest, or if keen criticism be brought 
into play to point out errors in fact, errors in logic, or errors 
in practice. 
It may be profitable and interesting rapidly and briefly to 
contrast the stand-point in science and in practice from 
which our Society starts, with that of the period which we 
now commemorate as our National Centenary. 8 
ANNUAL ADDRESS. 
I think it may be truthfully asserted, that in Obstetrics and 
Gynecology the progress in science, and consequently the 
improvements in practice, have been greater during the past 
one hundred years than the whole advance made during the 
previous ten centuries. Much also of the learning of the 
past, which had been lost or buried in oblivion, has been 
brought to light, and has given an impetus to new investiga- 
tions and new discoveries. The literature of one hundred 
years ago was so extremely limited, that it is not probable 
that a single private library in Europe contained thirty vol- 
umes devoted to subjects relating to Obstetrics and Gynecol- 
ogy, or that any physician in this country possessed one 
quarter of this number of volumes. The works on Mid- 
wifery by English authors, published during the preceding 
one hundred years, and which I mention in the order of 
their date of publication, were by Giffard, Chapman, Bur- 
ton, Smellie, Pugh, Cooper, Lake, Johnson ; “The Anatomy 
of the Gravid Uterus,” by William Hunter, published in 
1774; Hamilton’s “Elements of the Practice of Midwifery,” 
White on “ The Management of Pregnant and Lying-in Wo- 
men,” and Rigby’s Essay on “Uterine Hemorrhage,” pub- 
lished in 1775. The books previously published by Eng- 
lish authors were obsolete, and indeed were of little value. 
With the exception of the works by Giffard, Smellie, Hamil- 
ton, White, Rigby, and William Hunter, those I have just 
mentioned represent the knowledge of the day, chiefly ac- 
quired from Continental authors, rather than original con- 
tributions to science. The works of Guillemeau, Puzos, 
Mauriceau, Peu, Dionis, Astruc, La Motte, Levret, and 
Daventer had appeared in English translations, and Roe- 
derer’s “ Elementa Artis Obstetricise ” was undoubtedly well 
known to some. German literature was not then cultivated 
in England, and we may suppose it to have been wholly un- 
known to any members of the profession in this country, 
and Roederer, who wrote in Latin, is probably the only Ger- 
man writer then known to obstetricians. The teaching of 
P'ries at Strassburg, of Crantz at Vienna, of Meckel at 
Berlin and greater than all, that of Georg Wilhelm Stein, ANNUAL ADDRESS. 
9 
was limited in its influence, during the lifetime of these 
men, to those countries where the German language was 
spoken. At the present day so many, both in England and 
in this country, are familiar with German literature, that it 
is no longer safe to appropriate as original what has been 
previously published by some German author. 
In 1776, there can hardly be said to have been any litera- 
ture on the Diseases of Women, for Gynecology as a science 
had then no existence. Astruc on “ Diseases of Women,” 
which had been translated into English, was the only work 
exclusively devoted to this subject. There was much inci- 
dentally alluded to in works on Surgery and the Practice of 
Medicine, and many important papers in the Transactions 
of Scientific Societies, particularly in France, but this 
knowledge had not been culled out and brought together 
by a class of industrious and useful workers who are now 
so numerous. Hence much of the knowledge of Gyne- 
cology, which it is evident from the writings of Aetius and 
Paulus TEgineta, belonged to the profession down to the 
seventh century, finds no place in the Medical literature of 
the eighteenth. 
The speculum and the uterine probe, by means of which, 
chiefly, this department of the profession has been raised to 
the rank of a special science, had been known and probably 
were used to a limited extent by a few, as they are men- 
tioned by several writers of the seventeenth century ; but no 
allusion to either of these instruments can be found by any 
writer in the English language, and it is not probable that a 
single man in England or America ever made use of either 
of them until within the past half century. 
If we now compare the obstetrical science of a hun- 
dred years ago with that of to-day, the contrast will be still 
more striking. The work of William Hunter on “ The Anat- 
omy of the Gravid Uterus,” published in 1774, was a contri- 
bution to science, exceeding in value and importance any 
before made to Obstetrics, and it will stand for all time. He 
laid a solid foundation on which to build up Obstetrics as a 
science, and his name will be enrolled among the Band 10 
ANNUAL ADDRESS. 
of Immortals. More recent investigations in the same di- 
rection have demonstrated the distinction in anatomical 
structure and arrangement, in physiological functions, and in 
pathological changes between the cervix and the body of the 
uterus. The facts that the wonderful developments which 
take place in the structure of the uterus during gestation for 
the nutrition and retention of the fecundated ovum, pertain 
exclusively to the body of the uterus, that it is the lining 
membrane of this part of the organ alone which undergoes 
such remarkable changes during menstruation, gestation, 
and the puerperal period, and that forms the decidua and 
participates in the development of the • placenta, and that 
the changes which take place in the cervix during gestation 
are solely those which prepare this portion of the uterus for 
the function of parturition, are the great additions to our 
knowledge of the anatomy of the uterus of the past fifty 
years. As a natural deduction from these new truths in the 
anatomy and physiology of the organ, it has been learned 
that the pathology of the cervix differs from that of the 
body in its proclivity to disease and its tolerance of trau- 
matic injuries, the gravity of the influence of disease or 
traumatism on the general health, and the tendency to res- 
toration either spontaneously or by the resources of art. 
Our predecessors a hundred years ago had only a crude 
general knowledge of the anatomy and functions of the 
ovaries. The discovery of the independent existence of the 
ovule by Von Baer was the beginning of a series which have 
now unfolded the intimate structure and function of these 
organs. The processes of ovulation and the formation and 
significance of the corpus luteum are now understood, while 
much obscurity in regard to generation has been cleared up. 
How difficult and uncertain must have been the diagnosis 
of pregnancy in obscure cases — which are by no means 
rare — when there was no knowledge of the physiological 
changes which pregnancy effects in the cervix uteri, when 
auscultation of the sounds of the fetal heart and the uterine 
souffle was unknown, when ballottement and the intermittent 
contractions of the gravid uterus had never been pointed ANNUAL ADDRESS. 
11 
out, all of which are now presumed to be known by every 
one who asks the confidence of the public as an obstetric 
practitioner. 
Of the diseases of pregnancy, chloro-anemia and albu- 
minuria— the two most important of all — had never been 
recognized or described. It may also be added, that little 
was known a century ago, in regard to the pathology and 
appropriate treatment of the serious nervous affections, 
chorea, eclampsia, and the various paralyses. 
The pathology of the decidua and ovum had then received 
no attention. Hypertrophy of the decidua, vesicular degen- 
eration of the chorion, fatty degeneration of the placenta, 
and the blood transformations in the placenta, which until 
recently were believed to be due to inflammation in this 
organ, find no place in any obstetric work published forty 
years ago. As the pathology of the ovum and the uterine 
system has been developed, so there has been a correspond- 
ing advance in our knowledge of the causes, prevention, and 
treatment of abortion and its consequences. 
On the other hand, any physician, a century ago, who 
would have ventured to produce abortion on account of pro- 
longed vomiting and inability to retain nutrition, would un- 
doubtedly have been regarded both by the profession and 
the public as reckless, unscrupulous, and unprincipled. The 
moral right under any circumstances to induce premature 
labor, had been earnestly discussed prior to the period that 
we are now considering. But it is only within a very recent 
date, that the ethical sense of the profession has settled the 
question that it becomes the duty of obstetricians to resort 
to this procedure when a careful analysis of all the condi- 
tions of the case and sound reasoning have decided that it 
is a necessary measure to give a chance for saving the life 
of the child without adding materially to the risk of the 
mother, and in a still larger number of instances, when it is 
imperative in order to save the mother, disregarding the 
probabilities in regard to the child alone. 
If we compare the knowledge of Mauriceau, of La Motte, 
of Giffard, of Smellie, as to the mechanism of parturition 12 
ANNUAL ADDRESS. 
with that of all well-informed obstetricians of the present 
day, we must come to the conclusion that the successful re- 
sults obtained by the greatest accoucheurs were the triumphs 
of individual genius, rather than the scientific application of 
established laws. The presenting part was sought, but the 
relations of the presenting part to the different points of the 
superior strait were not recognized or studied. The differ- 
ent steps of flexion, descent, rotation, extension, and external 
rotation had never been analyzed or described. The suc- 
cessive changes in the relations of the diameters of the fetus 
to the diameters of the pelvis in normal labors being un- 
known, all attempts to aid a difficult labor by the resources 
of art could have been governed by no scientific principles 
and must have been experimental. From the philosophic 
study of the mechanism of delivery, has resulted an approxi- 
mation to definite rules of practice in every variety of pre- 
sentation and position, which, although far from the perfec- 
tion of exact science, is in remarkable contrast with the blind 
groping of our predecessors. What a flood of light has been 
thrown by the numerous observations of many minds, on 
the various causes of dystocia and the resources of art which 
may overcome it! In no one point has the advance been 
more striking, more positive and more important, than in 
respect to the use of the forceps. It may be confidently as- 
serted that no obstetrician, of acknowledged position, would 
“confess with regret, that towards the end of thirty years’ 
practice, I found much less occasion for the use of instru- 
ments than I had in the beginning” or would “conclude that 
the person, who, in proportion to the extent of his practice, 
meets with the most frequent occasion for the use of the in- 
struments knows least of the powers of nature,” as did Bard, 
our first American author on Obstetrics, and he undoubtedly 
represented the accepted opinions of the profession, with but 
few exceptions, until within the last decade. It was univer- 
sally held that the use of the forceps was attended with great 
risk to the mother and child, and therefore that they never 
were justifiable unless all hope of natural delivery was at an 
end and symptoms of exhaustion began to appear. But at ANNUAL ADDRESS. 
13 
the present day, the danger from the use of the forceps, when 
the head is in the pelvic cavity or pressing on the perineum, 
is regarded as so trivial, as compared with the danger to 
both mother and child from delay, that the terse enunciation 
of the law, by Dr. George Johnston, recently the distin- 
guished Master of the Rotunda Hospital, Dublin, that, “ Our 
established rule is that so long as nature is able to effect its 
purpose without prejudice to the constitution of the patient, 
danger to the soft parts, or the life of the child, we are in 
duty bound to allow the labor to proceed ; but as soon as 
we find the natural efforts are beginning to fail, and after 
having tried the milder means for relaxing the parts or stim- 
ulating the uterus to increased action, and the desired effects 
not being produced, we consider we are in duty bound to 
adopt still prompter measures, and by our timely assistance 
relieve the sufferer from her distress and her offspring from 
an imminent death,” must be accepted as a settled tenet in 
Obstetrics. The glamour of danger which obscured percep- 
tion as to when the use of the forceps is indicated un- 
doubtedly originated in confounding the difficulty and skill 
demanded in their use, in the comparatively few cases where 
they are required when the head is at or above the superior 
strait, as being equally true in the many cases where we now 
use the instruments when the head is in the cavity. 
A study of the history of the use and abuse of ergot, might 
serve “ to point a moral and adorn a tale ” as illustrating 
how settled convictions and practice change with the pro- 
gress of science and the accumulation of experience. For a 
series of years, it was often administered to accellerate par- 
turition, until slowly it became known that its use sometimes 
resulted disastrously to the mother and was always attended 
with considerable danger to the child, and it was found that 
we had safer means for stimulating the inert or exhausted 
uterus ; so that at the present day, I believe it to be rarely 
given for this purpose, while we still find it an invaluable 
agent, when delivery has been accomplished, in securing the 
woman against the danger of post-partum hemorrhage, and 
in notably diminishing the liability to after-pains. ANNUAL ADDRESS. 
The most wonderful of all the discoveries that has been 
made in obstetric practice is the use of Anesthetics, which, 
when properly administered, have no injurious effect upon 
either mother or child, but by which, the dread and horror 
that haunts many a poor woman for weeks before labor is 
in a great measure changed to a feeling of safety and immu- 
nity from the greatest of all suffering that human nature is 
called upon to endure; which calms the extreme agitation 
and mental excitement that labor often produces in nervous 
women; by which the physical pains of parturition have 
been greatly relieved or abolished, and the nervous shock 
and exhaustion of delivery in many cases averted ; which 
accellerates the termination when the progress of labor is 
retarded from pain occasioned by previous disease, and where 
the irregular and partial contractions cause intense and al- 
most constant pain, but have no effect to advance the labor; 
and in other cases, by overcoming spasmodic contraction of 
the cervix and tetanic rigidity of the perineum, while in the 
class of cases where the anesthetic retards labor, the relief 
from pain, and the protection from exhaustion, more than 
compensate for the delay ; and which has contributed 
greatly to reduce the mortality from puerperal convulsions ; 
and has rendered painless and easy of execution many ob- 
stetric operations, and made others possible and safe, that 
would be dangerous and fearfully agonizing without this 
agent. 
Who at the present day, could ever consent to assume 
the responsibility of a midwifery case, and watch for hours 
by the bedside of a woman suffering agony beyond that of 
most surgical operations, if the new science of the present 
century were blotted out, and all the consequent improve- 
ments in practice forgotten. 
Conceive the helplessness of one ignorant in a great 
measure of the anatomy and physiology of the organs in- 
volved in the phenomena that he is to watch and assist to a 
safe termination! Knowing nothing of the mechanism by 
which the process is normally accomplished and but little of 
our present resources for overcoming dystocia, looking upon 
14 ANNUAL ADDRESS. 
15 
the forceps as an instrument of terror, only to be resorted to 
when it has been demonstrated that delivery can never be 
otherwise accomplished, powerless to relieve agony by an 
anesthetic which still permits the essential phenomena to 
go safely on, having but an imperfect conception of the 
diagnosis and danger to mother and child from placenta 
previa and no acquaintance with our greatly improved 
methods of managing such cases, with no knowledge of the 
real pathology of convulsions or of the treatment by which 
the fatality of this fearful complication has been reduced at 
least seventy-five per cent., with only a general, crude notion 
of the puerperal phlegmasise, and quite unconscious of the 
existence and still more of the special symptoms of such 
puerperal affections as thrombosis, embolism, pyemia, and 
septicemia, we can only compare him, trite as the compari- 
son is, with the mariner tossed on the open sea, without 
chart or compass. 
The most condensed review of the new literature, the 
progress of science, and the improvements in practice in 
Gynecology during the past century, is not possible within 
the limit of time permissible on this occasion. It could 
only be a catalogue of authors, more numerous than that of 
all writers on these subjects, whose names have come down 
to us from previous generations ; an illustrative record of 
how new discoveries in general pathology had illuminated the 
special pathology of this department of medicine; an out- 
line picture of the fertility of invention in instruments to aid 
in diagnosis and to secure results from operations that were 
never before possible; a meagre history of how new 
methods of physical exploration had determined the exact 
character, limits, and relations of diseases before known, and 
had revealed many which previously had never been de- 
scribed or understood; and a bare reference to the inge- 
nuity and genius which has devised the many operations for 
restoring those lesions of parturition which rendered life a 
burden to the sufferer and to those connected with her, and 
to the wise, scientific audacity which had established as 
iustifiable conservative surgery, those bold operations which, 16 
ANNUAL ADDRESS. 
within two decades, have added at least fifty thousand years 
to the life of women. 
In the inauguration of a National Society, whose avowed 
purpose is the promotion of science in all that relates to 
Obstetrics and the Diseases of Women, I am sure that it 
would be offensive to the good taste of its founders, for me 
to allude to what they have individually achieved already in 
this direction. Those who are really successful in making 
positive contributions to science or art may well be content 
with the decision of posterity as to the value of their work. 
Contemporaneous judgment is often partial or prejudiced. 
Individual, sectional, and even national bias, may obscure 
the perception and thus exaggerate or depreciate the impor- 
tance of those things which subsequent generations will esti- 
mate at their true worth. Science is cosmopolitan ; and in 
this age, the intercourse between the educated of different 
nationalities is becoming so much more intimate, and an 
acquaintance with the literature of different languages is 
becoming so much more general, that all intellectual and 
scientific progress must be more or less reciprocal; neither 
theory or practice can long continue in a groove; members 
of our profession, in all its departments, must become broader 
and more eclectic, not blind followers of local or national 
supposed authorities; and such phrases as the Irish, the 
English, or the Continental “ School of Obstetrics,” or the 
“ American School of Gynecologists,” must inevitably soon 
become obsolete. 
Individual or national pride may well be encouraged so 
far as it stimulates earnest effort. We have a right to cher- 
ish the memory and honor the names of Bard, Stearns, 
McDowell, Dewees, Meigs, Hodge, Miller, and Channing, 
as our illustrious dead, who have won an acknowledged 
position in our department of science; but for those who are 
now living, the judgment of the future is not yet definitely 
determined. No man can safely rest upon his past achieve- 
ments. Unfortunately, men who have justly earned a high 
position, have in some instances, either from lack of moral 
sense, or wise discretion, or sound judgment, fallen and lost the respect and the confidence of their peers, and conse- 
quently have failed to retain the reputation which their abil- 
ity and merit would otherwise have secured. 
In conclusion, let me express the hope that this Society, 
both as individuals and as an organized body, may command 
the approval of the highest and most cultivated judgment 
of the scientific world, and not incur the reproach which Job 
in his bitterness uttered, “Ye are all physicians of no 
value.” 
ANNUAL ADDRESS. 
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